A vocal group of frustrated nurses is threatening to reject a three-year tentative contract with the provincial government because it doesn’t come with written guarantees that more nurses will be hired for short-staffed hospital units.

The voting deadline for the tentative deal is Jan. 21 and, as Postmedia stories have been documenting contract details this week, nurses have been voicing their concerns in emails and on social media that the deal doesn’t go far enough to hold employers to account.

This, even though the Health Employers Association of B.C., which negotiates on behalf of the government, agreed to a provision in the $3.99-billion contract in which nurses working on short-staffed units will be given an hourly bonus ranging from $3 to $5 an hour. The “working short” premiums could cost taxpayer-funded health facilities as much as $100 million a year, according to the union bargaining team which insists that it is putative and is, therefore, a huge incentive for hospitals to fill vacancies.

The cost of the premiums is considered an “unfunded liability” to health employers so amounts owing to nurses would come out of hospital and other budgets already allocated by the provincial government. It remains to be seen whether the ministry of health would hand over more money to health authorities to cover the premiums.

Naysayers are skeptical that the premiums will achieve their purpose; some say it will still be cheaper to pay the premiums than to hire new nurses. Nearly $200 million was paid in overtime to nurses last year.

Health Employers spokesman Roy Thorpe-Dorward said in an interview that the agreement “requires employers to take all reasonable efforts to fill shifts, including going to full overtime rates.

“The working short premium is intended to compensate nurses who are required to work short if a shift can’t be filled. The goal of employers is to minimize the number of times this premium would be paid.”

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There are hundreds of nursing vacancies posted on the HealthMatch B.C. website but not even the union knows how many more jobs need to be filled, so the contract provides for a workload assessment process over the next year meant to show what “safe staffing” levels are for each hospital unit. The union can also press for more hirings in other ways, as it did at St. Paul’s Hospital last year.

The “working short premium” as it is called, will kick in on April 1, 2020 and B.C. Nurses Union CEO Umar Sheikh has said that many of the 6,000 casual nurses should be converted to regular, permanent positions to help plug the “four million hours” when hospitals are short staffed.

B.C. Nurses Union CEO Umar Sheikh.PNG

Sheikh acknowledged it may be difficult to find and hire enough registered nurses, registered psychiatric nurses and licensed practical nurses. Recent reports by the Canadian Nurses Association and the Canadian Institute of Health Information show that nationally, there is an alarming slowdown in the growth of employed nurses.

The annual growth rate fell to 0.7 per cent from 2016 to 2017, the slowest in a decade. In 2017 (the last year for which data is available), a total of 4,271 nurses were registered for the first time in B.C., but in the same year 3,135 retired, so there was a net gain of only 1,136 nurses. By comparison, Ontario had net gains of 1,941 nurses and Alberta had 1,183.

Nurses say they can’t speak on the record during the ratification process but they have been reaching out in droves — off the record — to articulate their worries.

“We have been working short staffed for years and the government has not lived up to their previous contract negotiations. The current health care system is run based on nurses doing crazy amounts of overtime. We are tired, but most of us do overtime because we feel bad for our co-workers and don’t want to leave them working short.”

Sheikh told his union members the working short premiums are high enough that hospitals will be compelled to hire extra staff rather than pay it. For example, the $5 per hour premium represents an 11.38-per-cent wage increase on top of the 7.75-per-cent increase nurses will get over three years. (Although the contract calls for a two-per-cent increase each year, an extra 1.75 is due to nurses this year as a carryover from the last contract.)

“The working short premium represents a commitment by the employers — (one) we haven’t seen before.”

Nurses union president Christine Sorensen told members in the same teleconference that the understaffing in hospitals is “simply unsustainable.” The contract addresses priorities nurses identified before bargaining, she said, including compensation for all time worked, wage increases, benefits protection, workloads and safe staffing levels, and a premium “for those times when you did not have staff (on leaves) replaced.”